连续性静脉-静脉血液滤过在治疗急性呼吸窘迫综合征中的应用价值  

Application value of continuous veno venous hemofiltration in patients with acute respiratory distress syndrome

作　　者：唐小卿[1] 王春全[1] 俞丽[1] 邓宁[1] 熊白龙 TANG Xiao-qing;WANG Chun-quan;YU Li;DENG Ning;XIONG Bai-long(Department of Intensive Medicine,the Ninth People’s Hospital of Chongqing,Chongqing　400700,China)

机构地区：[1]重庆市第九人民医院重症医学科,重庆400700

出　　处：《临床肺科杂志》2018年第5期887-890,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨连续性静脉-静脉血液滤过在治疗急性呼吸窘迫综合征中的应用价值。方法急性呼吸窘迫综合征患者72例根据入住病床单双号,分为观察组36例与对照组36例,对照组给予机械通气治疗,观察组在对照组治疗的基础上给予连续性静脉-静脉血液滤过治疗。结果观察组的ICU住院时间与总住院时间明显少于对照组(P<0.05)。治疗后各时间点Pa O_2和Pa O_2/Fi O_2值都有明显上升,Pa CO_2值都明显下降(P<0.05)。治疗后观察组的血清IL-6与TNF-ɑ值与对照组对比有统计学意义(P<0.05)。观察组的呼吸机相关肺炎、恶心呕吐、肺出血等并发症发生率为8.3%,对照组为33.3%,观察组明显低于对照组(P<0.05)。结论连续性静脉-静脉血液滤过治疗急性呼吸窘迫综合征患者能改善动脉血气指标,促进降低炎症因子水平,缩短患者的住院时间,减少并发症发生率。Objective To investigate the application value of continuous veno venous hemofiltration in patients with acute respiratory distress syndrome.Methods 72 patients with ARDS in our hospital were divided into the observation group(36 cases)and the control group(36 cases)according to single and double beds.The control group was received mechanical ventilation treatment,and the observation group was given continuous veno venous hemofiltration treatment based on the control group treatment.Results The ICU hospitalization time and total hospitalization time of the observation group were significantly less than those of the control group(P<0.05)(ICU).The levels of PaO 2 and PaO 2/FiO 2 increased significantly,and the level of PaCO 2 decreased at each time point after treatment(P<0.05).The serum TNF-ɑand IL-6 value 72h after treatment in the observation group were significantly lower than in the control group(P<0.05).The incidence of ventilator-associated pneumonia,nausea and vomiting,pulmonary hemorrhage and other complications was 8.3%in the observation group and 33.3%in the control group(P<0.05).Conclusion Continuous veno venous hemofiltration in treatment of patients with ARDS can improve arterial blood gas index,it can effectively reduce the levels of inflammatory factors,so as to shorten the hospitalization time and reduce the incidence of complications.

关 键 词：连续性静脉-静脉血液滤过 急性呼吸窘迫综合征 动脉血气 炎症因子 

分 类 号：R563.8[医药卫生—呼吸系统]